When to Expect Accutane to Start Working?

I just started Accutane and I was wondering when I should expect it to start working. Also, are there any preventative things I can do while I'm on it.

Doctor Answers 8

Accutane starts working usually after a month but varies considerably

Most cases a month or two, but there can be great variability with some patients noting improvement in two weeks and others not for four months. It is difficult to tell which category you would fall into.

One observation: those patients who notice dry, peeling skin should expect their blemishes to improve shortly thereafter.

If you are dismayed when your acne does not magically resolve within a few months do not throw in the towel. Sometimes, Accutane will not seem to be doing much at all for four months then kick in. This is especially true if you have acne on the trunk.

I can recall one young man, let's call him Daniel, who presented with a bowed head. All I could see was his scalp. When he lifted his head so I could view his face, it was studded with large, ugly cysts. Nearly his whole face was covered with abscesses. If there was a youth he needed Accutane this was the one. Yet his mother obstinately refused Accutane (I NEVER pressure someone into using this medication). After attempting treatment after treatment, I was about to give up. I placed him on Accutane. It did nothing. Nothing at all but make me look like a false prophet. Four months on Accutane and he bore the same number of cysts he started with.

I remember attending a course at the American Academy of Dermatology meeting "What to do for the Patient who Fails Accutane." I thought of Daniel during the whole lecture. When I returned to Virginia Beach and my office, ironically my first patient that day was Daniel. With dread I opened the door, steeling myself for another I told you so from his mother. Amazingly, between the fourth and fifth month, Daniel's acne had cleared. Almost totally. I took him off Accutane for two months, gave him another course and his complexion was entirely clear.

About ten years later, now a college graduate, Daniel returned for treatment of different dermatologic problem. He was a handsome, confident young man. He thanked me profusely for placing him on Accutane and I thanked him for having faith in me when I told him that the Accutane would work.

As for measures you can take to prevent the side effects. Be sure to moisturize your skin at least twice a day. Wear a sunscreen. Find a good lip balm such as Carmex or Blistex. If your nose becomes dry, I recommend Ayr saline gel.

There is some evidence that oral Vitamin E helps make the Accutane work more efficiently. However, a recent paper found that Vitamin E orally, did not improve the dryness associated with Accutane. (Most of us were surprised by this result, since we have been recommended that for years to prevent dryness....and I still recommend 200 I. U.).

Follow any other instructions from your dermatologist, including being aware of potential side effects.

Finally, if Accutane does not seem to be working for you, be patient.

Virginia Beach Dermatologist
4.7 out of 5 stars 14 reviews

Accutane and Begining Therapy

Isotretinion takes 20+ weeks to fully work, its all dependent on the total dose used.  Most people see results in 6-8 weeks after starting and will see a flare of the acne at the beginning.  I have my patients do light chemical peels and skin care/facials during therapy.  If they have acne scars and facial redness, ill use pulsed dye laser and microneedling for improvement.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 190 reviews

When will Accutane work?

Accutane will usually start to work within the first 1-2 months, but some patients will actually worsen during this initial phase, and this is normal too. Each patient will have a different experience, and very few patients are still breaking out towards the end of their treatment. When a patient is still experiencing breakouts there are few options to what can be done: we can finish the 6 months, take a 3 month break, then resume another course, or we can extend the treatment beyond the 6 months (and this is dependent on you Doctor's clinical judgement), and we can consider other reasons for why a break out is still occurring, we should consider a hormonal component if the patient is female which can also be treated successfully.

While on Accutane, I would only use gentle facial cleansers, avoid using any acne topical therapies, avoid supplemental Vitamin A, and use sun protection daily, and do not forget to use a good lip balm several times per day.

Good luck, Dr. P.

Kaleroy Papantoniou, MD, FAAD
Great Neck Dermatologic Surgeon
5.0 out of 5 stars 31 reviews

When Does Accutane Start Working?

The answer is simple....

It starts immediately.

But results can take time.

I have had patients who did not see major results until a few months into treatment.

Everybody's course is individual.

Michael A. Greenberg, MD
Elk Grove Village Dermatologist
4.9 out of 5 stars 17 reviews

What to expect on Accutane for Acne

When I start patients on Accutane, I generally instruct them to expect a few things: the first is dryness.  Nearly all patients have skin and lip dryness while taking the medication, yet the vast majority are able to manage it symptomatically (i.e. lip balm, moisturizers). This remains throughout the course of treatment. The second thing to expect is an initial flare of the acne; most patients have this as well.  This at least lets us know that the medication is having an effect.  After 2-3 months, most then begin to subside and clear.  Patience is definitely key for acne treatment with this medication.

Dornechia George Carter, MD
Dallas Dermatologist

When to Expect Accutane to Start Working?

Accutane will kick in right away to make you dry but the acne effects don't kick in till the second month. Some patients do get worse initially but this depends on the dose and the severity of their acne initially. Complete clearance doesn't usually occur till the third to fourth month in most of my patients. There is usually an 85-90% response to accutane so your chances to completely clear are excellent.

Alim R. Devani, MD, FRCPC
Calgary Dermatologist
4.9 out of 5 stars 14 reviews

Accutane is a great medicine for those who need it to clear their acne

Thanks for your question. Accutane is a great medicine for those who need it to clear their acne. One of
the most important factors is the dose that is given when we are treating acne. Your board-certified
dermatologist will determine the dose, which in medical terms, is usually 1 mg/kg/d. the course of
Accutane is 20 weeks – and you need to be on it for the full course to get the maximum benefits. I consult
with m y patients in this simplistic but realistic way. During the first 8 weeks, you actually may break out
more from the treatment. The next 8 weeks is when most of the acne will resolve, and the last 4 weeks is
what I call overkill – the remaining acne should leave during that time. Remember, that every patient is
different – Accutane works quickly in some and takes longer to “kick in” in others. And once you are off
the drug, it will still continue to have an affect for quite some time after your last pill. Work with your
dermatologist and they will help you with the process.

Michael Gold, MD
Nashville Dermatologic Surgeon
4.0 out of 5 stars 18 reviews

Accutane takes weeks

Be patient. The results can be gradual, and some patients actually get worse first, but Accutane is the best treatment for severe acne. Avoid the sun, take vitamin E and B complex, keeping the skin hydrated seem to decrease side effects. In very severe flares, prednisone is used for a few days to decrease the inflammation.

Mary P. Lupo, MD
New Orleans Dermatologist
5.0 out of 5 stars 18 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.